We only pay benefits for services provided by healthcare providers recognised by ahm (Recognised Providers). To be recognised by us, providers need to meet certain standards, called the Recognised Provider Recognition Criteria.
Under these standards, Recognised Providers need to:
- be registered or hold a licence under any relevant state or territory legislation to render treatment for which recognition is sought;
- be professionally qualified or a member of a professional body recognised by ahm;
- be in independent private practice;
- maintain accurate and comprehensive patient records in English;
- use facilities that meet our standards; and
- meet other criteria that we believe are reasonable.
When providers no longer meet these standards, providers may be taken off our Recognised Provider list and we’ll no longer pay benefits for their services. You can still visit the provider, but since they’re no longer recognised, you would need to pay for their services in full.
Rest assured, we don’t take someone off our list of Recognised Providers unless we have reasonable grounds for doing so.
Want to find a Recognised Provider? Use our simple search tool.